Schulte Laura H, Jürgens Tim P, May Arne
Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, D-22046, Germany.
J Headache Pain. 2015 Feb 15;16:14. doi: 10.1186/s10194-015-0495-7.
Certain environmental stimuli are frequently reported as typical triggers of migraine pain. Whether these so-called triggers are independent precipitators of migraine pain or mere symptoms of the premonitory phase of migraine remains to be elucidated.
In this retrospective cohort study of 1010 migraine patients of a tertiary headache center we assessed the frequency of common trigger factors, premonitory symptoms and accompanying symptoms as well as basic headache characteristics and demographic data.
Premonitory symptoms with an onset of 2 or more hours prior to the headache were present in 38.9% of migraine patients, the most frequent being a tense neck, phonophobia and difficulty concentrating. There was a clear overlap of certain trigger factors and the presence of corresponding premonitory symptoms: flickering or bright light as a trigger was associated with higher frequency of photophobia in the premonitory phase. The same applied to the presence of food craving and osmophobia in the premonitory phase and certain foods or odours as trigger factors.
Our data thus support the view that commonly reported trigger factors of migraine are not so much independent precipitators of migraine pain, but that they are most likely just misinterpreted results of enhanced attention to certain stimuli mediated by typical premonitory symptoms of migraine pain.
某些环境刺激因素常被报道为偏头痛疼痛的典型触发因素。这些所谓的触发因素究竟是偏头痛疼痛的独立诱发因素，还是仅仅是偏头痛先兆期的症状，仍有待阐明。
在这项对一家三级头痛中心的1010名偏头痛患者进行的回顾性队列研究中，我们评估了常见触发因素、先兆症状和伴随症状的发生频率，以及基本头痛特征和人口统计学数据。
38.9%的偏头痛患者在头痛发作前2小时或更长时间出现先兆症状，最常见的是颈部紧张、畏声和注意力难以集中。某些触发因素与相应先兆症状的出现明显重叠：闪烁或强光作为触发因素与先兆期畏光频率较高相关。这同样适用于先兆期对食物的渴望和恐嗅症以及某些食物或气味作为触发因素的情况。
因此，我们的数据支持这样一种观点，即偏头痛常见的触发因素与其说是偏头痛疼痛的独立诱发因素，不如说它们很可能只是由于偏头痛疼痛的典型先兆症状介导而对某些刺激增强关注的错误解读结果。
